Androgenetic Alopecia In Men Research Articles

Sparse hairs below frontal hair line are early sign of androgenetic alopecia in men

Sparse hairs below frontal hair line are early sign of androgenetic alopecia in men

Adenosine increases anagen hair growth and thick hairs in Japanese women with female pattern hair loss: A pilot, double‐blind, randomized, placebo‐controlled trial

Adenosine upregulates the expression of vascular endothelial growth factor and fibroblast growth factor-7 in cultured dermal papilla cells. It has been shown that, in Japanese men, adenosine improves androgenetic alopecia due to the thickening of thin hair due to hair follicle miniaturization. To investigate the efficacy and safety of adenosine treatment to improve hair loss in women, 30 Japanese women with female pattern hair loss were recruited for this double-blind, randomized, placebo-controlled study. Volunteers used either 0.75% adenosine lotion or a placebo lotion topically twice daily for 12 months. Efficacy was evaluated by dermatologists and by investigators and in phototrichograms. As a result, adenosine was significantly superior to the placebo according to assessments by dermatologists and investigators and by self-assessments. Adenosine significantly increased the anagen hair growth rate and the thick hair rate. No side-effects were encountered during the trial. Adenosine improved hair loss in Japanese women by stimulating hair growth and by thickening hair shafts. Adenosine is useful for treating female pattern hair loss in women as well as androgenetic alopecia in men.

Prevalence and types of androgenetic alopecia in Shanghai, China: a community-based study

There are ethnic differences in the prevalence and types of androgenetic alopecia (AGA). Although there have been several reports on the prevalence and types of AGA in caucasian and Asian populations, there are very few data on a Chinese population that have been derived from a sufficient number of samples. To estimate the prevalence and types of AGA in a Chinese population, and to compare the results with those in caucasians and Koreans reported previously in the literature. A population-based cross-sectional study was carried out in 7056 subjects (3519 men and 3537 women) from May 2006 to December 2006 in a community of Shanghai. Questionnaires were completed during face-to-face interviews at the subjects' homes. The degree of AGA was classified according to the Norwood and Ludwig classifications. The prevalence of AGA in Chinese men was 19.9%, and the prevalence of female pattern AGA in men was 0.1%. The most common type in men was type III vertex (3.5%). The prevalence of AGA in women was 3.1%, while male pattern AGA was found in those aged over 50 years (0.4%), and the most common type was type I (Ludwig classification) (1.4%). A family history of AGA was present in 55.8% of men and 32.4% of women with AGA. The prevalence of AGA in Chinese men was lower than in caucasian men but was similar to that in Korean men; however, over the age of 60 years it was approaching that in caucasian men but was higher than that in Korean men. The most common type in Chinese men with AGA was type III vertex. Interestingly, the prevalence of AGA in Chinese women was lower than that in Korean women and caucasian women, and type I was the most common type (Ludwig classification).

A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men

An alternative to currently marketed topical minoxidil solutions is desirable. To assess the efficacy and safety of a new 5% minoxidil topical formulation in a propylene glycol-free foam vehicle in men with androgenetic alopecia (AGA). This was a 16-week, double-blind, placebo-controlled trial of 5% minoxidil topical foam (MTF) in 352 men, 18 to 49 years old. At week 16, 143 subjects continued on an open-label phase to collect 52 weeks of safety information on 5% MTF. At week 16 compared with baseline, there was a statistically significant increase in (1) hair counts in the 5% MTF group versus placebo (P < .0001) and (2) subjective assessment of improved hair loss condition (P < .0001) in the 5% MTF group versus placebo. The 5% MTF was well tolerated over a 52-week period. There was no collection of efficacy data beyond 16 weeks. We believe that 5% MTF is a safe and effective treatment for men with AGA.

Finasteride 1 mg has no inhibitory effect on omeprazole metabolism in extensive and poor metabolizers for CYP2C19 in Japanese

To examine the inhibitory effect of finasteride 1 mg on the metabolism of omeprazole in genetically determined extensive (EMs) and poor metabolizers (PMs) for CYP2C19 in young healthy Japanese male subjects. Twenty-four volunteers participated in this study, among whom 12 were homozygous EMs and 12 were PMs for CYP2C19. A single center, controlled, randomized, open, crossover study with a 5 day washout between the two study periods was performed. Each of the six EMs and PMs received a single oral 20 mg dose of omeprazole on day 1 (treatment I). After a 5 day washout period, these subjects received 1 mg of finasteride once a day for three consecutive days, and a single oral 20 mg dose of omeprazole was co-administered on day 3 (treatment II). The 12 other EMs and PMs received treatments I and II in reverse. Plasma samples were collected for up to a 12 hours postdose of omeprazole, and the pharmacokinetic parameters of omeprazole were determined. The geometric mean ratio (GMR) for the AUC((0-12 hr)) of omeprazole when co-administered with finasteride/omeprazole alone is 1.13 (90%CI, 1.03, 1.25) and 0.96 (0.88, 1.05) in EMs and PMs, respectively. Finasteride did not significantly alter C(max), T(max) and t(1/2) in both genotypes. Finasteride 1 mg, widely used for the treatment of androgenetic alopecia in men, did not meaningfully increase omeprazole exposure (20 mg) in both EMs and PMs for CYP2C19. These results indicate that finasteride does not meaningfully inhibit CYP2C19 activity in vivo at the dose of 1 mg.

A study of patterns of androgenetic alopecia in men: an Indian perspective

British Journal of DermatologyVolume 152, Issue 3 p. 572-574 A study of patterns of androgenetic alopecia in men: an Indian perspective S. Grover, S. Grover Department of Dermatology, Command Hospital (Air Force), Bangalore 560007, Assam, India E-mail: sanjivgrover@indiatimes.comSearch for more papers by this author S. Grover, S. Grover Department of Dermatology, Command Hospital (Air Force), Bangalore 560007, Assam, India E-mail: sanjivgrover@indiatimes.comSearch for more papers by this author First published: 17 March 2005 https://doi.org/10.1111/j.1365-2133.2005.06442.xCitations: 4Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume152, Issue3March 2005Pages 572-574 RelatedInformation

Selective non-steroidal inhibitors of 5α-reductase type 1

The enzyme 5α-reductase (5αR) catalyses the reduction of testosterone (T) into the more potent androgen dihydrotestosterone (DHT). The abnormal production of DHT is associated to pathologies of the main target organs of this hormone: the prostate and the skin. Benign prostatic hyperplasia (BPH), prostate cancer, acne, androgenetic alopecia in men, and hirsutism in women appear related to the DHT production. Two isozymes of 5α-reductase have been cloned, expressed and characterized (5αR-1 and 5αR-2). They share a poor homology, have different chromosomal localization, enzyme kinetic parameters, and tissue expression patterns. Since 5αR-1 and 5αR-2 are differently distributed in the androgen target organs, a different involvement of the two isozymes in the pathogenesis of prostate and skin disorders can be hypothesized. High interest has been paid to the synthesis of inhibitors of 5α-reductase for the treatment of DHT related pathologies, and the selective inhibition of any single isozyme represents a great challenge for medical and pharmaceutical research in order to have more specific drugs. At present, no 5αR-1 inhibitor is marketed for the treatment of 5αR-1 related pathologies but pharmaceutical research is very active in this field. This paper will review the major classes of 5αR inhibitors focusing in particular on non-steroidal inhibitors and on structural features that enhance the selectivity versus the type 1 isozyme. Biological tests to assess the inhibitory activity towards the two 5αR isozymes will be also discussed.

Ketocazole as an adjunct to finasteride in the treatment of androgenetic alopecia in men

Dihydrotestosterone (DHT) binding to androgen receptors (AR) in hair follicles is commonly accepted as the first step leading to the miniaturizing of follicles associated with androgenetic alopecia (AGA). Testosterone is converted to DHT by the enzyme 5α-reductase. Finasateride a 5α-reducase inhibitor blocks the production of DHT and is currently used to treat AGA. The inhibition is not complete but a reduction of DHT systemically and in the scalp is accomplished. Ketoconazole has been clinically shown to be effective in the treatment of AGA. In this paper, evidence is presented to support the hypothesis that ketoconazole 2% shampoo has a local disruption of the DHT pathway. It is proposed that using ketoconazole 2% shampoo as an adjunct to finasteride treatment could lead to a more complete inhibition of DHT and thus better treat AGA.

Pilot study of a novel treatment for androgenetic alopecia using enriched cell culture medium: clinical trials

Androgenetic Alopecia (AA) afflicts a large part of the population and of the many treatments available today none is completely satisfactory. Testing the efficacy and safety of a novel topical treatment for AA which is based on cell culture medium supplemented with insulin, thyroxin and growth hormone (CCM). The 48 participants classified as androgenetic alopecia Type II, III or IV on the Hamilton scale, concluded a randomized, vehicle-controlled, double-blind trial of 6 months duration. Under occlusive cover the gel was self applied for at least 3 hours daily. Evaluation was based on hair counts, investigator global assessment and participants self-administered questionnaire. Cessation of hair loss was reported by most participants within 28 weeks, and further confirmed by the hair count (HC) in ~80% of participants. Moreover, as early as 4 months after the start of the treatment, a time dependent increase of up to 50% in HC was observed. The average change in HC between the two groups differed significantly (p=0.007), with values of 4.1% for control and 13.8% for CCM. Following 4 months of treatment, a time dependent increase in HC (>10%) above minimal was observed in 55% of the CCM and 25% of the control and this trend continued. At 6 months 63% of the CCM and 33% of the control group exhibited increase of HC higher than 10%. The average increase in HC in the CCM and the control groups was 17.1% and 8.9% respectively (p=0.035). Self evaluation questionnaires revealed a time dependent increase in satisfaction in the CCMusers compared to the control. While the average score at T2 was similar in CCM and control (2.7 and 2.6 respectively), the score at T6 in the CCM increased to 5.9 and decreased to -0.4 in the control (p=0.007). Global-clinical evaluation following six months treatment revealed significantly (p=0.02) more hair loss in the control group (40%) compared to the CCM (7%) treated group. CCM was found effective in treating androgenetic alopecia in men. It induced cessation of hair loss, increased rate of hair growth and appearance of new hair. No side effects were reported or observed.

A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men

Background: Topical minoxidil solution 2% stimulates new hair growth and helps stop the loss of hair in individuals with androgenetic alopecia (AGA). Results can be variable, and historical experience suggests that higher concentrations of topical minoxidil may enhance efficacy. Objective: The purpose of this 48-week, double-blind, placebo-controlled, randomized, multicenter trial was to compare 5% topical minoxidil with 2% topical minoxidil and placebo in the treatment of men with AGA. Methods: A total of 393 men (18-49 years old) with AGA applied 5% topical minoxidil solution (n = 157), 2% topical minoxidil solution (n = 158), or placebo (vehicle for 5% solution; n = 78) twice daily. Efficacy was evaluated by scalp target area hair counts and patient and investigator assessments of change in scalp coverage and benefit of treatment. Results: After 48 weeks of therapy, 5% topical minoxidil was significantly superior to 2% topical minoxidil and placebo in terms of change from baseline in nonvellus hair count, patient rating of scalp coverage and treatment benefit, and investigator rating of scalp coverage. Hair count data indicate that response to treatment occurred earlier with 5% compared with 2% topical minoxidil. Additionally, data from a patient questionnaire on quality of life, global benefit, hair growth, and hair styling demonstrated that 5% topical minoxidil helped improve patients' psychosocial perceptions of hair loss. An increased occurrence of pruritus and local irritation was observed with 5% topical minoxidil compared with 2% topical minoxidil. Conclusion: In men with AGA, 5% topical minoxidil was clearly superior to 2% topical minoxidil and placebo in increasing hair regrowth, and the magnitude of its effect was marked (45% more hair regrowth than 2% topical minoxidil at week 48). Men who used 5% topical minoxidil also had an earlier response to treatment than those who used 2% topical minoxidil. Psychosocial perceptions of hair loss in men with AGA were also improved. Topical minoxidil (5% and 2%) was well tolerated by the men in this trial without evidence of systemic effects. (J Am Acad Dermatol 2002;47:377-85.)

Androgenetic alopecia in the man

Androgenetic alopecia (AGA) occurs in approximately 40% of men at the age of 40 and 50% at 50, respectively. Especially for young men progressive hair loss can be distressing. Therefore, understanding of these patients' concerns is important for appropriate management. Current understanding of the pathophysiology of AGA mainly focuses on androgen metabolism as it affects hair growth. As a result, pharmacologic treatment has made considerable progress through the introduction of selective 5 alpha-reductase inhibition with finasteride. In placebo-controlled clinical trials in men with AGA, treatment with oral finasteride proved to be effective. Minoxidil is the only pharmacological substance for topical application with proven efficacy. So far, other treatment modalities have no proven efficacy in clinical trials, so that their use cannot be recommended. Options for advanced AGA not amenable to pharmacologic treatment are autologous hair transplantation and hair replacement, both of which have recently also made progress in terms of cosmetic appeal.

Acne: effect of hormones on pathogenesis and management.

In the pathogenesis of acne, androgen hormones play a crucial role. In the treatment of acne, hormonal therapies provide valuable alternatives to standard modalities in selected women. Although numerous factors contribute to the development of acne, the requirement for androgens is absolute and is one that allows for effective treatments in women through inhibition of androgen expression. The two prerequisites for androgen expression at the level of the pilosebaceous unit are the presence of androgen in the form of either testosterone or dihydrotestosterone; and functioning androgen receptors. A third component may be the metabolism of androgen precursors to active androgens within pilosebaceous units. Hormonal treatment of hyperandrogenism (acne, hirsutism, androgenetic alopecia) such as that seen in polycystic ovary syndrome, centers on reduction of circulating androgen levels and androgen receptor blockade. Combination oral contraceptives represent the primary treatment modality for reducing circulating androgens from ovarian and, to a lesser degree, adrenal sources. Newer formulations may also have clinically significant androgen receptor blocking and 5alpha-reductase inhibiting effects. Newer oral contraceptives have high safety profiles and are used widely internationally for this purpose. Androgen receptor blockers currently in use include spironolactone, cyproterone acetate, and flutamide. Androgen receptor blockers are frequently combined with oral contraceptives to achieve optimal results in selected women. In women with adrenal hyperplasia, low-dose corticosteroids may be added to reduce adrenal androgen precursors. Inhibition of enzymes of androgen metabolism in the pilosebaceous unit remain largely investigational in the treatment of acne, although the benefit of 5alpha-reductase (type 2) inhibition is established in androgenetic alopecia in men. This article reviews the essentials of hormonal influence in acne pathogenesis, discusses the hormonal therapies most utilized in the treatment of acne, and the pre-treatment evaluation of women in whom hormonal therapies are being considered.

The prevalence and types of androgenetic alopecia in Korean men and women

There are racial differences in the prevalence and types of androgenetic alopecia (AGA). There have been several reports on the prevalence and types of AGA in the general population of caucasians, but few studies on Koreans with samples of sufficient numbers have been reported. To obtain a more precise estimate of the prevalence and types of AGA in Korean men and women and to compare the results with those in caucasians. The prevalence and types of AGA were analysed in 10,132 Koreans (5531 men and 4601 women) who had visited the Health Examination Centre at Kyung Hee University Hospital for regular health examinations between December 1997 and July 1999. To classify the degree of hair loss for each subject, the Norwood classification was used in men and the Ludwig classification in women. For AGA in men, 'female pattern' was added to the Norwood classification. In Korean men, the prevalence of AGA (Norwood III or above) at all ages was 14.1%. It increased steadily with advancing age, but was lower than that of caucasians: 2.3% in the third decade, 4.0% in the fourth decade, 10.8% in the fifth decade, 24.5% in the sixth decade, 34.3% in the seventh decade and 46.9% over 70 years. Type III vertex involvement was the most common type in the third decade to the seventh decade; over 70 years, type VI was most common. A 'female pattern' was observed in 11.1% of cases. In Korean women, the prevalence of AGA (Ludwig I or above) at all ages was 5.6%. It also increased steadily with advancing age: 0.2% in the third decade, 2.3% in the fourth decade, 3.8% in the fifth decade, 7.4% in the sixth decade, 11.7% in the seventh decade and 24.7% over 70 years. Grade I was the most common type up to the sixth decade; over 60 years, grade I and II were similar in prevalence. Grade III (total baldness) was not observed. A family history of baldness was present in 48.5% of men and 45.2% of women with AGA. The prevalence of AGA in Korean men and women was lower than that in caucasians, as recorded in the literature. Korean men tend to have more frontal hairline preservation and show a more 'female pattern' of hair thinning than caucasians. Therefore, 'female pattern' should be added to the classification of AGA.

Drug treatment of androgenetic alopecia in men

Fur eine ganze Reihe von heute erhaltlichen Therapeutika wird vorgegeben, dass mit ihnen die androgenetische Alopezie gestoppt werden kann, beziehungsweise sogar neues Haarwachstum angeregt werden kann. Allerdings wurden nur die auserlich anzuwendenden Wirkstoffe 17α-Estradiol und Minoxidil sowie das einzunehmende Finasterid wissenschaftlich validen Untersuchungen unterzogen. Im Rahmen dieser Untersuchungen konnte eine gewisse Wirksamkeit der 17α-Estradiollosung, eine relativ gute Wirksamkeit der Minoxidillosung und eine uberzeugende Wirksamkeit von Finasterid gezeigt werden.

Management of androgenetic alopecia

Background Androgenetic alopecia (AGA) is the most frequent cause of hair loss affecting up to 50% of men and 40% of women by the age of 50.Methods This paper outlines the current status of diagnosis and offers guidelines for optimal management of AGA in both men and women.Results The diagnosis of AGA can usually be confirmed by medical history and physical examination alone. A trichogram can be useful to assess the progression of the hair loss. A scalp biospy is diagnostic but usually not required. In women with signs of hyperandrogenism, investigation for ovarian (polycystic ovarian disease) or adrenal (late-onset congenital adrenal hyperplasia) disorders is required. Mild to moderate AGA in men can be treated with oral finasteride or topical minoxidil. Oral finasteride at the dosage of 1 mg/day produced clinical improvement in up to 66% of patients treated for 2 years. The drug is effective for both frontal and vertex hair thinning. Medical treatment with finasteride or minoxidil should be continued indefinitely since interruption of therapy leads to hair loss with return to pretreatment status. Mild to moderate AGA in women can be treated with oral antiandrogens (cyproterone acetate, spironolactone) and/or topical minoxidil with good results in many cases. Hair systems and surgery may be considered for selected cases of severe AGA both in men and in women.Conclusions Patients with AGA should be informed about the pathogenesis of the condition. If used correctly, available medical treatments arrest progression of the disease and reverse miniaturization in most patients with mild to moderate AGA.

Management of androgenetic alopecia

Androgenetic alopecia (AGA) is the most frequent cause of hair loss affecting up to 50% of men and 40% of women by the age of 50. This paper outlines the current status of diagnosis and offers guidelines for optimal management of AGA in both men and women. The diagnosis of AGA can usually be confirmed by medical history and physical examination alone. A trichogram can be useful to assess the progression of the hair loss. A scalp biospy is diagnostic but usually not required. In women with signs of hyperandrogenism, investigation for ovarian (polycystic ovarian disease) or adrenal (late-onset congenital adrenal hyperplasia) disorders is required. Mild to moderate AGA in men can be treated with oral finasteride or topical minoxidil. Oral finasteride at the dosage of 1 mg/day produced clinical improvement in up to 66% of patients treated for 2 years. The drug is effective for both frontal and vertex hair thinning. Medical treatment with finasteride or minoxidil should be continued indefinitely since interruption of therapy leads to hair loss with return to pretreatment status. Mild to moderate AGA in women can be treated with oral antiandrogens (cyproterone acetate, spironolactone) and/or topical minoxidil with good results in many cases. Hair systems and surgery may be considered for selected cases of severe AGA both in men and in women. Patients with AGA should be informed about the pathogenesis of the condition. If used correctly, available medical treatments arrest progression of the disease and reverse miniaturization in most patients with mild to moderate AGA.

A hair growth questionnaire for use in the evaluation of therapeutic effects in men

BACKGROUND: Male-pattern hair loss (androgenetic alopecia) is a common clinical condition in adult men that is often associated with negative self-perception and has been the target of a number of therapeutic interventions. Despite the importance of self-perceptions of hair growth and appearance with such interventions, no standardized validated questionnaire exists for use in clinical trials. OBJECTIVE: Develop and evaluate a questionnaire to measure patient-perceived changes in hair growth and appearance in clinical trials of medical intervention for androgenetic alopecia in men. METHODS: Literature review and focus groups with men having androgenetic alopecia initially identified 28 potential questions. These questions were assessed in an observational study (n = 204) and a placebo-controlled clinical trial (n = 181). RESULTS: The final questionnaire contained seven global questions addressing change since the start of the study in satisfaction with hair appearance (three questions), hair growth and appearance, size of the bald spot, and slowing of hair loss. Significant differences favoring active treatment over placebo were evident for all seven questions by 6 months in a clinical trial. CONCLUSIONS: This standardized questionnaire can be used to assess patient perceptions of hair growth in clinical trials of men with androgenetic alopecia.

S124 Variants of myxoid cysts: Diagnosis and treatment

Background Androgenetic alopecia (AGA) is the most frequent cause of hair loss affecting up to 50% of men and 40% of women by the age of 50.Methods This paper outlines the current status of diagnosis and offers guidelines for optimal management of AGA in both men and women.Results The diagnosis of AGA can usually be confirmed by medical history and physical examination alone. A trichogram can be useful to assess the progression of the hair loss. A scalp biospy is diagnostic but usually not required. In women with signs of hyperandrogenism, investigation for ovarian (polycystic ovarian disease) or adrenal (late-onset congenital adrenal hyperplasia) disorders is required. Mild to moderate AGA in men can be treated with oral finasteride or topical minoxidil. Oral finasteride at the dosage of 1 mg/day produced clinical improvement in up to 66% of patients treated for 2 years. The drug is effective for both frontal and vertex hair thinning. Medical treatment with finasteride or minoxidil should be continued indefinitely since interruption of therapy leads to hair loss with return to pretreatment status. Mild to moderate AGA in women can be treated with oral antiandrogens (cyproterone acetate, spironolactone) and/or topical minoxidil with good results in many cases. Hair systems and surgery may be considered for selected cases of severe AGA both in men and in women.Conclusions Patients with AGA should be informed about the pathogenesis of the condition. If used correctly, available medical treatments arrest progression of the disease and reverse miniaturization in most patients with mild to moderate AGA.

New aspects in hair transplantation for females.

In the overall spectrum of plastic surgery, hair transplantation for females still plays a marginal role. Previously applied standard methods (standard grafts) could not produce aesthetically satisfying results, so that many female patients who could have benefitted from an operation were discouraged from doing so. It was not until the method of using minigrafts exclusively to cover large areas of androgenetic alopecia in men was developed that acceptable treatment possibilities were also made available to women. The main applications of hair transplantation for females are: androgenetic alopecia, hereditary changes in the hairline, traumatic alopecia, and cosmetic indications. Since 1986 all female patients were exclusively treated with mini- and micrografts in one to two or three sessions. Performing hair transplantation calls for a high degree of sensitivity on the part of the surgeon with respect to the woman and her expectations. With the mini- and micrograft technique new aspects in hair transplantation for females can be offered.

The psychological effects of androgenetic alopecia in men

Despite the prevalence of androgenetic alopecia among men, little is known about its psychological effects. This investigation examined the psychosocial sequelae that balding men attribute to hair loss and compared balding and nonbalding men in personality functioning. Subjects included 63 men with modest balding, 40 men with more extensive balding, and 42 nonbalding controls. All anonymously completed a battery of standardized psychological measures. Reported effects of balding reflected considerable preoccupation, moderate stress or distress, and copious coping efforts. These effects were especially salient among men with more extensive balding and among younger men, single men, and those with an earlier hair-loss onset. Relative to controls, balding men had less body-image satisfaction yet were comparable on other personality indexes. Personality correlates of the psychological responses to hair loss were identified. Although most men regard hair loss to be an unwanted, distressing experience that diminishes their body image, balding men actively cope and generally retain the integrity of their personality functioning.